Healthcare Provider Details

I. General information

NPI: 1285565598
Provider Name (Legal Business Name): SHALIZA ALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15430 FOOTHILL BLVD
CASTRO VALLEY CA
94578-1009
US

IV. Provider business mailing address

605 SORENSON RD APT 44
HAYWARD CA
94544-3060
US

V. Phone/Fax

Practice location:
  • Phone: 510-963-4388
  • Fax:
Mailing address:
  • Phone: 341-314-6993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number753680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: